EVALUATION OF A VITAL PULPOTOMY PROCEDURE IN TEETH

牙齿活髓切断术的评估

• 批准号: 3424897
• 负责人: RAY A WALTERS
• 金额: $ 1.14万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-04-01 至 1988-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3424897
• 关键词: dental amalgam; dentures; endodontics; human subject; human therapy evaluation; mastication; periodontium disorder; root canal therapy; silver; touch

It is generally accepted that an overdenture may be indicated when the remaining teeth and periodontium cannot support a conventional partial denture. The patients' best interests are often fulfilled by not rendering them edentulous. The purpose of this clinical and histological study of 20 patients is to evaluate the feasibility of utilizing vital pulpotomy procedures as a substitute for complete endodontic treatment in single-canal teeth to be retained for overdenture support. A method is proposed that eliminates the need for endodontic treatment on overdenture abutment teeth. This approach reduces treatment time and cost, yet provides increased efficiency in mastication and sensory perception as well as a state of well being and increased confidence to the patient. Three teeth that satisfy criteria for overdenture abutments are identified in one arch of each patient. These teeth will be treated, as necessary, to achieve a healthy periodontium. Immediate dentures are fabricated and at delivery, the abutment teeth each have a pulpotomy performed utilizing a selective sterile technique. Following removal of pulpal tissue to a selected depth, hemorrhage is controlled until stopped. Dentinal chips are obtained from the pulpal wall and placed over the pulp. Dycal is placed over the dentinal chips to approximately a 1 mm. depth and when set, silver amalgan is gently layered in using lateral condensation to avoid pressure on the pulp. The remaining pulp chamber is filled and root surface contoured to meet the dimensions of conventional overdenture abutments. Complete root canal therapy will be performed if any of the pulpotomized teeth exacerbate. Post-insertion evaluations will be performed at 1 day, 2 weeks, 3 months, 1 year and 2 years. Histologic evaluation will be made when the third tooth (control) is extracted at the third month after insertion of the overdenture. The remaining two roots will serve as long-term overdenture abutments.

人们普遍认为，当出现以下情况时，可以指示覆盖义齿： 剩余的牙齿和牙周组织无法支持传统的局部修复 假牙。 患者的最大利益往往通过不提供服务来实现 他们无牙颌。 这项对 20 名患者进行的临床和组织学研究的目的是 评估利用活髓切断术作为治疗方法的可行性 可以替代单管牙的完整牙髓治疗 保留用于覆盖义齿支撑。 提出了一种无需进行牙髓治疗的方法 覆盖义齿基牙。 这种方法减少了治疗时间和成本， 但提高了咀嚼和感官知觉的效率 以及患者的健康状态和增强的信心。 确定了三颗满足覆盖义齿基台标准的牙齿 在每位患者的一侧足弓处。 这些牙齿将根据需要进行治疗，以 实现健康的牙周组织。 即刻假牙已制作完成并在 分娩时，每颗基牙都要进行活髓切断术 选择性无菌技术。 去除牙髓组织后 选择深度，控制出血直至停止。 牙科芯片是 从牙髓壁获取并放置在牙髓上。 Dycal 已放置 覆盖牙本质碎片约 1 毫米。深度和设置后，银色 汞合金通过横向冷凝轻轻分层以避免压力 在纸浆上。 剩余的牙髓室被填充并且根面 轮廓符合传统覆盖义齿基台的尺寸。 如果发生活髓切断术，将进行完整的根管治疗 牙齿加剧。 插入后评估将在第 1 天、第 2 天进行 几周、三个月、一年和两年。 将进行组织学评估 当第三颗牙齿（对照）在术后第三个月拔除时 插入覆盖义齿。 剩下的两个根将作为 长期覆盖义齿基台。